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Procainamide: NAPA

BHCG tumor marker for what? Not sure but I answered chorocarcinoma. Cos the three choices
were pancreatic, colon and lungs
MCV calculation
5HIAA carcinoid tumors
I had 5 bb panels (was thinking maybe this was the reason I failed. Although I did understand
but the questions were a bit confusing. Not sure with my answers)
Proteus vulgaris and mirabilis indole tests
Bb and Heme Case studies
Hydatid cyst fluid
Rh stuff
ABO descripancies
Antacid overdose? What lab test should you conduct?
Ouchterlony reading

-coagulation
-Prolonged PT, PTT, and thrombin after collecting from catheter= heparin contamination
– Question with mixing study that was performed with a prolonged PTT that couldn’t be
corrected=
DRVVT
-Another question with two pt’s ran in duplicate (PT and PTT). The PTT seemed to always be
prolonged but PT looked ok= I picked check the CaCl/phospholipid reagent delivery
– Patient is on coumadin therapy, what will be affected= Decreased protein C
-Hematology-
-Lot’s of stomatocytes= liver disease
-Burr cells= uremia
-Picture of target cells with hemoglobin C crystals. The white count was high on instrument 1, so
a second instrument was used with a stronger lysing agent, and the white count was corrected= I
picked anti-lysing target cells are what increased the white count.
-A sodium citrate tube was drawn for a HCT on a pt but the hematocrit was abnormal. Options
were recollect in heparin (what I picked), recollect with increased anticoagulant, recollect with
decreased anticoagulant, etc.
-Question that gives a red blood cells count, HGB, and HCT. I did the rule of 3 and found that
the HGB didn’t meet the rule of 3 because it was too high= I picked check for lipemia (elevates
HGB)
-Picture of PBS with an elevated reticulocyte count and howell jolly bodies in the RBC’s.= I
picked stain with prussian blue stain in order to see the retic nuclei
-what is composed of DNA?=howell jolly bodies
-what falsely decreases ESR=vibration
-ESR is increased, what is NOT a cause=I picked macrocytes because macrocytes don’t rouleux.
Other options were rouleux, increased globulins, inflammation, etc.
-Chemistry-
-Question about lactic acid collection=separate from serum and put on ice
-Question about coefficient of variation
-Carbon dioxide electrode measures what?= pH
-Question about patient that had a random glucose >200 and an FPG >126. What do you do
next?= I picked repeat the FPG. Other options were diagnose with diabetes mellitus, perform
OGTT, etc.
-Immunology-
-Man tested positive for syphilis 2 years ago but may have again, how would you test him?-RPR
-Question with a graph with 3 peaks related to a bacterial infection= I picked that the first peak
was the antigen in the stool, the second peak was IgM (goes up and then down quickly), and the
third peak was IgG (goes up and levels off a little).
-Person tested positive for HIV-1 and HIV-2 but western blot was indeterminate. What do you
do?= I picked do CD4 count. Other options were repeat western blot, repeat HIV-2, etc.
-Blood Bank- It felt like I had a lot of questions
– 1 small antibody ID panel. The antibodies that matched up were Lewis A Lewis B. Question
asked about the characteristics of the antibodies.= I picked that they are lipids absorbed onto
RBC from plasma.
– There was a positive DAT on cord blood; mother is Rh pos, baby is Rh neg. What is most likely
coating the baby’s red cells?= I picked K (kell). Other options were A&B, D, Lewis, etc.
-Picture of what looks like cold agglutinins (I got this picture 2 different times during the test).=
The first time I picked cold reacting antibody. The second time the options were different so I
went with Paroxysmal cold hemoglobinuria. Mycoplasma infection was an option but there
wasn’t a lot of WBC’s in the picture so I didn’t pick Mycoplasma.
-What phase can rouleux not be detected in?= I picked AHG phase because a positive 37C,
negative AHG, and positive auto=rouleux
-Picture of ABO type with mixed field reaction in the forward type= I picked that patient was
transfused with O blood
-Picture of AB in forward reaction, and weak reactions in back type= I picked incubate at room
temp because probably cold agglutinins
-Question about an adsorption that had been done twice, and antibody screen is positive=I
picked perform antibody ID panel
-If a patient is type A with Lewis a+b- what substance will be on their red cells= I picked Lewis a
but other options were (A, Lea), (H, A, Lea), (Lea,Leb), etc.
-Micro- no parasite questions, 2 mycology questions
– Only 1 micro picture. Bile esculin +, NaCl-, alpha hemolytic, looked like a strep=Group D strep
gallolyticus/bovis
-TSI slant K/A H2S+, PD-,= Salmonella antisera was only organism that fit
-Question with lactose fermenter, ODC+, lysine -, etc.=Enterobacter cloaca but I’m not sure
-Rotavirus= stool
-CSF storage= incubate at 35C
-Hair perforation test= Trichophyton metagrophyte and T. rubrum
-Good way to detect Legionella infection=antigen detection in urine
-Question about a lesion on an arm= I picked sporothrix schenckii but I’m not sure. Other
options were cryptosporidium, microsporum, etc.
-Mycoplasma can’t be treated with penicillin= no cell wal

1. eosinophils in urine sediments indicates what ? interstitial nephritis


2 calculate creatinine clearance : (Urine creatinine X urine Volume/Plasma creatinine x
time in minutes)x (1.73/body surface area)
3. what is measured in procainamide ? NAPA
4. LEARN YOUR IMVIC REACTIONS YOU WILL AT LEAST 5 QUESTIONS AND TRY
TO TURN EACH SEGMENT INTO A SENTENCE; THIS REALLY HELPED
5. Glomerulonephritis is found linked to which microorganism? Strep pyogenes
6. disease correlations : basophilic stippling and high lead results. Is this correct
7. what happens to CO2, PCO2, and pH when blood is left around for an extended period
of time? low, low, and high
8 make a list of organisms that must be worked on under the hood
After ingesting moth balls what you see in PBS? Heinz Bodies
AB Rh: POSITIVE patient has reaction on forward A 4+ and B 1+ Rh 4+. What will you report? I
answered AB Rh +
Gram negative cocci after a jaw surgey? Veilonella spp
QC on BhCG has weak positive in QC + and negative on QC neg what will you release? Release
as positive BhCG.
MCV day 1: 78, MCV day 2: 77 MCV day 3: 76 MCV day 4: 62, what is the probable reason?
Wrong patient.
Which leukemia + for Philadelphia?
High LAP score?
Low LAP score?
Smudge cells usually seen in? ALL
A picture of alternaria fungus.
A picture of Candida geothricum.
Olive oil for. M.furfur
calculate precision.
Youre given a list of cv, which of them is best?
Given lab results, which one is suggestive of Lactic acidosis?
Calculate how many units of blood to be taken given the antibodies and their percentages.
Calculate corrected WBC given the retics and WBC count. In this case the differential was only
50. Im not sure but what i did is: WBC Uncorrected x 50 / nucleated RBC x 50. I did the 100 the
answere is not on d choices, but when i calculated using 50 as factor, the answer was on the
choices.
Study antibodies of HAV.
RPR negative FTABS +? Release positive.
Cryoprecipitate and FFP allowable time of use if Ref. temp is 4 degree celcius. Based on AABB
standard.
CK MB normal, Tn I is high? Myocardial infarct.
First to increase in MI? Myoglobin.
Study electrophoresis: Albumin, alpha 1, alpha2, beta, globulin.. Which is high given the disease,
or the other way around.
There was a fungal colony which is violet to purple in color on the plate. Im not sure, i chose
Fusarium.
Biochemicals of Salmonella typhimurium and Kleb. oxytoca
I had one simple BB panel. it was positive for Anti-Fya and anti-E.
Majority of lymphocytes. T Cells
Premature new born was transfused? why? I answered to compensate to the loss blood becoz of
frequent phlebotomy. Not sure though..
Pheochromocytoma : Metanephrines
coccaine metabolite? Benzoylecgonine..
1. Transudates are a. purulent b. has many bacteria c. usually noninflammatory
2. All about DAT and ABO discrepancies. I recommend you study all the discrepancies
the cause and solutions of each
3. difference between p. aeruginosa and p. putida – growth at 42’C
4. S. epidermidis in catheterized patients
5. Microccus
6. Pictures of ANA patterns and dse association
7. Picture of Curvularia
8. Geotrichum candidum
9. Levey-Jennings chart
10. Random and systematic error
11. aggregating substances
12. picture of poikilocytes
13. Hbnopathy assoc w naphthalene poisoning
14. Blood pictures and ds associations
15.electrophoresis question.
16.CPDA-1 expiry date
17. coagulation pathways and dse correlations
18. metabolic acidosis
19. pappenheimer bodies
20. CLL, leukemoid reaction
21. Mixing studies
22. graph abt asp, collagen, epinephrine
23. Donor deferrals
24 Hepatitis markers

Some recalls:
child ate mothball accidentally: Heinz bodies
M. furfur: olive oil
gave 4 different equation with SD & mean; asked which would be more productive CV (So know
how to calculate)
something to do with LDL and HDL: heparin manganese solution
5HIAA test: Carcinoid tumors
same effect as Procainamide:NAPA
Zygomycetes (from mycology) (Not sure what were the options or what I chose)
A picture of Histoplasma Capsulatum: identify
A picture of Blastomyces dermatitis: ( i think thats what it was; don’t know for sure)
Cryo was pooled; when is the new expiration?: 4 hrs
FFP was thawed at 11:15 am and left for the OR: came back to blood back at 11:40 and the temp
was 11degC; what should the tech do? I chose accept and return to the inventory as it was less
than 30 minutes with improper temp
Lots of DAT and Elution question
Lots of panel (please please and super please listen to the ab identification lectures by the
BBGUY)
Something about dosage effect of antiE
Lots of ABO discrepancies asking why and what to do? (Please understand Sohal’s BB high yield
notes; it is beautifully categorized and explained)
Lots of diagrams with iron, ferritin, TIBC, bilirubin, urobilinogen and then asked what type of
disease?
KNOW IMVIC reactions: I have had 2 /3 question from there
K. pneumoniae vs K. Oxi….(See i don’t svn remember the whole name) (As soon as I saw it, I
knew indole pos)
How would you differentiate diid Yersinia species: chose motility
know the X factor and V factor H. influenza and how it correlates with S. Aureus.
sensitivity for all the gram (+) organisms ( asked bat Bacitracin, positive camp test,)
Lots of ANA questions(remember the numbers and the patterns)

CDPA-1 how many days?


Which Mycobaterium (pictured) incubated for weeks and exposed tolight become
yellow? picture of Kansassi (yellow colonies)

You received a nasopharyngal swab specimen for ROTAVIRUS, what to do? (I choose
call for clarification of the request)

Which org requires safety precaution? Choices: Aspergillus, Sporothrix schenckii

Picture of Howell Jolly bodies

Blood from newborn had high PT, high PTT and TT, bleeding from cord also…reason…is
a) afibriginogemia b) lupus inhibitor c) factor 8 deficiency d) factor 10 deficiency

FFP is thawed at 8am when is the expiration? Choices: 8pm, 8am etc..

Speckled Pattern is for? Choices: RA, SLE etc..

Question about what antibody causes HDFN when dad was O neg rr, and mom is A pos,
R1R1…choices were antibody…. D, c, A, or B

Every other parameter on CBC was ok, (MCV, RDW, RBC, PLT, WBC)..delta failure on
HGH is due to what…instrument malfunction, tourniquet too tight, wrong blood was
tested….

Lactic acid specimen has to handled how…..a) chilled and separated from cells b) heated
c) room temp incubation d) request EDTA sample only

Picture of Strongyloides stercolaris

LDL computation
Picture of Western Blot for HIV, read and interpret the results

Series of results of HGB results for 5 consecutive days, results in Day 3 is high, the
others are almost the same. What is the reason? Choices: machine malfunction,
collected too early, specimen left standing too long..

S. aureus ferments what? choices: mannitol, sucrose, lactose, fructose


Protein electrophoresis in pH 8.6 what is close to cathode? Choices: albumin & alpha 1,
gamma & beta, albumin & alpha 2..

A 70 year old man will donate, what will be the grounds of deferral given the following
screening tests: BP 140/90, Pulse 70, Temp 37 degrees the other choice is HBG of 120 or
125 I forget..
Donor will donate plasma. What will be the reason for deferring the donor; choices:
Donor received penicillin(I think?) for last week, confirmed Hep B infection last year I
forget the other choices..

Pt and ptt controls were abnormal qc repeated ptt was normal what will you do? –
replace thromboplastin or replace activator

What process will you do for Weak D? choices: DAT, IAT, elution/adsorbtion etc..

Choriocarcinoma

Picture of P. falciparum (identify)

Biochemical tests identifying Shigella (IMVIC, motility etc)

Question about immunodiffusion arcs: Ouchterlony (identity, partial, non-identity)

First step in agglutination? Choices: flocculation, sensitization, lattice formation

Graph of lag phase micro what are the IgG and IgM?

Elizabethkingia meningoseptica – meningitis is premature NBs

A result of CBC: increase WBC, the rest are normal. Platelets is 20. What is the blood
picture? (choices ranged from the normal or abnormal status of the ff PT, PTT,
Fibrinogen, D-Dimer)

A picture of bone marrow smear. Is it normal or abnormal blood picture?


A LOT of antibody identification, discrepancies and resolution (3-7 questions)

2mL of blood was filled only for a 5 mL of anticoagulant tube; what would happen for
results of apt? (decreased? Increased? Normal?)

O positive man had a strong anti-e, he will be incompatible with what percent of what
blood Rh type? (choices; it’s something like: 97% of O positive? 25% of A positive? I
forgot the others)

If the PT controls were okay and the aptt controls were okay, what do you do next?
Choices were replace thrombin, replace activator, etc.

What is the cv is the 80-100 mmol/L is within 2SDs (choices: 5.5% , 10%, 20%)

What is the purpose of Protein C and S? (choices: act as natural anticoagulant, activates
protein coagulants.. etc..)

What bacteria will show positive and negative for the following. Bile esculin, 6.5na,
Camp, bacitracin. (choices: S. pyogenes, S. agalactiae, Viridians, Enterococcus)

Slight agglutination only on RPR test. What to do next? (choices: Repost as positive, re-
calibrate and re-test, replaced new lot number, repeat testing using same kit)

Effect of increased/decreased aldosterone on Na and K

What’s wrong with this stain? blood smear shows pink buff on rbcs (choices: acid
alcohol is too strong, carbolfuchsin is used instead of safranin etc.. I forgot the other
choices)

Know common markers for B and T lymphs (CD 19, 20/ CD 2,3,5,7, 4/8 mature

Graph of 650 nm?

What does ISE measures?

How do you differentiate Yersinia enterocolitica vs Yersinia pestis? (I choose motility


but not sure)

What is the specific gravity of the 3mL urine diluted with 3mL H2O? Specific gravity is
1.024 before dilution. (choices: 1.024, 1.072, 1.048 etc..)
How do you know if the plasma used for PT has been contaminated with heparin?
(choices: test for PT, perform mixing studies.. etc.. I forgot the other choices)

Memorize mnemonics for IMVICs, TSIs, H2S producers, Oxidase and Urease producing
bacteria and others etc.

aHCG – Pacreatic CA or testicular?

Where does ALP is increased? (I choose the associated with bone disease; no Obj.
Jaundice in the choices)

Bernard Soulier syndrome – The question is long but the main differentiation that
caught my eye is “giant platelets”. The rest of the choices are not in sync with the
question. (No May-Hegglin in the choices so I choose Bernard S.)

What does 5HIAA in urine mean? (choices: renal disease, carcinoid tumors etc..)

Picture of Ascaris lubricoides ova (Identify)

Given: HDL was 34, Trig was 400, and cholesterol was 235. LDL was directly tested and
was 169. What to do next? (choices: repeat Trigly and recalculate LDL?, repeat Chole
and recalculated LDL? Recollect after 12 hours of fasting Etc.. I forgot the other choices)

A control blood smear was made that covered 60% of the slide. The red cells stained
pink while white cells had their nuclei stain dark blue to light blue. The white cells were
clustered at the tail end.
A) Accept
B) Reject – white cells clustered at tail
C) Reject – Red cell color is incorrect

Ran controls and PT was normal, PTT was abnormal. Replaced controls and got same
results. What should you do next?
A) Change out the Recombiplastin
B) Change out the CaCl
C) Rerun controls
D) Run patient tests

Exam Recalls:
Chemistry/Urinalysis
Transudates
Abnormal urine colors
Cast dealing with strenuous exercise
Difference between traumatic tap; hemorrhage
The difference between primary and secondary thyroidism —TSH
Know your enzymes –ALP AST, LD, etc [Wordsology’s high yield chemistry chart]
Know your Tumor markers –what cancer is associated with it. I got one with hCG—
testicular cancer –[Wordsology’s high yield chemistry chart]
Dilution question
Blood Gasses: Metabolic Acidosis/Respiratory Alkalosis etc. [know reference ranges;
clinical conditions]
Procainamide and NAPA
Immunology
DiGeorge Syndrome- Regarding T-Cell deficiency—Absence of Thymus
CD4: is it a) inducer b) phagocytic c) cytotoxic d) don’t remember the other choice
ANA patterns

Hematology
Picture of a peripheral blood smear with Plasmodium falciparum
Howell Jolly inclusion picture –what is it composed of? DNA-
One with Pappenheimer Bodies – what do you stain it with? –Confirm with Prussian
Blue
Know what anemias are considered normochromic normocytic
Hemoglobin C disease—Target cells
Picture of a peripheral blood smear with Plasmodium falciparum
COAGULATION
APTT; PT – Disseminated intravascular coagulation—Correlating the APTT: PT
FIBRINOGEN results [prolonged or not]
Know what factors are in the Intrinsic and Extrinsic Pathway, mixing studies
Blood Bank:
Felt like I had a lot of blood bank questions (my weakest subject) Know how to do
panels, DAT/ELUTION/ Subgroups of A
Criteria for Allogenic Donor Selection
CDPA-1 know its advantage

Microbiology/Mycology
Wordsology’s Gram Positive Cocci Chart! Had a question deal with +/- controls for Bile
Esculin; CAMP; NACL; Bacitracin
picture of Kansassi
Sterilization – 15 lbs –121C
ESBL
TSI reactions for Enterobacteriaceae –Bottom Line Approach Yellow & Purple book
Ziehl-Neilson—hot stain
Rotavirus – stool
Histoplasma capsulatum –tuberculate macroconidia
Sporothrix schenckii—Cigar bodies
Laboratory management:
One question about quality assuranc
Recalls

Hema (pictures)/STAINS: 8 items mostly pbs


PBS: Burr cells-uremia
What deficiency Teardrop cells? DNA

Stomatocytes:liver disease

Picture of trichuris trichiura

BLOOD BANK
8 questions either interpret or what should you do next….
Anti a Anti b Weak D Rh control A cells B cells
4+ 4+ 2+ 0 0 0

Anti-A Anti-B A cell B cell


4+ 4+ 2+ 2+

• About Micrococcus- (100 ug) Furazolidone resistant


• Favors growth of anaerobic gram negative bacilli- Vitamin K and hemin
• Purpose of potassium permanganate in auramine rhodamine-quenching agent to
enhance the color background
• A positive culture of sputum was stained. Carbolfucshin was added, washed,
decolorized and malachite blue was used as counter stain. Two entire field was scanned
and no acid fast bacilli were found. The most probably reason is: Inadequate scanning of
slide
• A patient has “whooping cough”, what specimen?- Nasopharyngeal swab
• RIST – Total IgE
• Graph of the platelet aggregation expressed in % transmittance for ADP, collagen and
epinephrine. Result was 0% transmittance ACE. abnormal ADP, Collagen, and
Epinephrine)

• Computation: SENSITIVITY AND SPECIFICITY

Positive (100) Negative (100)


Method 1 50 100
Method 2 60 88

• Formula of sensitivity Sensitivity = (TP/TP+FN) 100%

• Lewis Antibody – if Le and Se gene is inherited, one has Leb adsorbed unto RBC Le (a-
b+)
• Carbon dioxide ion selective electrode measure?pCO2
• Metabolic acidosis

• Result of lipase increased at Normal amylase (given reference value) saan daw
associated ?

Choices : acute AP, colon cancer, Duodenal obstruction etc.

• Why is it that serum bilirubin is preferably measured than amniotic fluid?


Choices: amniotic fluid exceeds linearity of the machine being used , amniotic fluid is
more difficult to extract, amniotic fluid has different biological components
• Characteristics of transudates at exudates
The question was clear yellowish peritoneal fluid with results ofRBC,WBC(Lymphocytes
80%)Glucose,Lipase,Amylase,LDH,Potassium
Choices: Viral transudate,Bacterial exudates etc etc etc (super detailed question and I
don’t know the answer )
• Hepatitis B marker
• Urolbilinogen :Colorless product of bilirubin metabolism
• HIV: repeat EIA
• Storage of virus: Lyophilized
• Sorage of CSF for culture
• Niacin pos w/ picture M.TB
• CML-diff count result
• Group O isoagglutinins
• Blood to be transfused to a GVHD pxmother to child -irradiated
• Dss association pseudo pelger huet anomaly
• Chronic heap-auto abs- anti smooth muscle
• Picture of teardrop cells:myelofibrosis of the newborn
• Partial D: structure protein altered
• Delta Check:comparison of present data with previous result
• Result increase potassium cause: tourniquet left for more than 10 mins
• Phase contrast microscope : living cells,ustained spx
• Diff morganella and providencia
• Acinetobacter
• Aeromnas
• Differentiate mature and immature blood cells: chromatin clumping
• Light hit, emit power: fluorometry
• Cloudy urine: hematuria
• Picture spherocytes:mild anemia
• Low in serum iron, low tibc, normal ferritin:anemia of chronic disease
• Homogenous pix: ssDNA
• Electrophoresis protein
• Thermistor
• Half life
• Encapsulated yeast seen in DM: C neoformans
• Haptoglobin
• Protein C and Protein S
• Causes thrombosis:C3
• S. aureus ferments: Mannitol
• Heparin-Manganese
• Specimen collection for uine
• Sperm collected for 2 hous-repeat collection
• Hgb electrophoresis
• MCV MCH MCHC
• BB Pannel
• Tap water bacilli- M. gordonae
• Kleihauer Betke Disk
• Ouchterlony

Here are my recalls:


1.DAT Interpretation, what to do next if it has 3+ on c3d only
2.night shift reconstituted controls using water from the water purifier. Why? (Expired
reagents) and volumetric pipette results were bad – why? (Improper calibration of
pipette)
5.Bx subgroup +mf on anti B
6.ABO DISCREPANCIES and how to remedy them. Anti-a and Anti-b. Both 4+. A and B
cells both 2+. How to resolve this discrepancy? (Report? Prewarm? Wash the cells and
retype?)
6.medtech performed AUTO ADSORPTION because of 4+ auto control But after
adsorption it has still 2+ what to do?
7.Decreased free PSA is associated with?
8.ANA PIC associated with which of the following choices: were anti ssa anti dsdna anti
mitoch anti smooth muscle, the pic was speckled
9.Cause of low NA? (Hypoproteinemia, Diabetes insipidus)
10.Exchange transfusion. Mother was AB NEG AND HAS ANTI D, C, I AND
LEWIS. BABY WAS O POS. What blood to be transfused on baby?
O RH NEG NEGATIVE FOR D C I ANTIGENS forgot other choices
11.if you are testing for MRSA, what to do? (Decrease the level of salt in the media
increase the methicillin conc of the disk, forgot other choices)

12.TIBC computation
13.cause of lack of agglutination after adding check cells on negative results
Two days old infant glucose strip positive. Clinitest negative. Cause? (Galactosuria,
Excess ascorbic acid, expired strip)

CA 19 9
Metabolite of PHENOBARBITAL
PROCAINAMIDE
SLEEP APNEA- Associated with pseudocholinesterase
Flurometer
Valinomycin- K
Cut off absorbance for HBEAG was 0.734 something. Specimen was 0.3. Interpret result
(Positive, Indetermine, Negative)
Stomatocytes associated with? (Burr cells)

1. Picture of Fusobacterium
2. A thin, gram-negative bacillus with tapered ends isolated from an empyema specimen
grew only on anaerobic sheep blood agar. It was found to be indole positive, lipase
negative, and was inhibited by 20% bile. The most probable identification of this isolate
would be:
a. Bacteroides
b. Fusobacterium
c. Clostridium
d. Porphyromonas
3. Picture of Taenia proglottid
a. Taenia saginata
b. Taenia solium
c, Dypilidium Caninum
4. Plate of Auer rods, where do you see them
a. AML
b. CML
5. A beta-hemolytic, catalasa positive, gram-positive coccus is coagulase negative by the
slide coagulase test. Which of the following es the most appropriate in identification of
this organism?
a. Report a coagulase-negative Staphylococcus
b. Report a coagulase-negative Staphylococcus aureus
c. Reconfirm the hemolytic reaction on a fresh 24-hour culture
d. Do a tube coagulase test to confirm the slide test
6. Hairy Cell plate, the picture looked blurry
a. atypic linfocite
b. hairy cell leukimia
c. normal linfocite
7. Plate of toxic granulation
8. During the past month, Staphylococcus epidermidis has been isolated from blood
cultures at 2-3 times the rate from the previous year. The most logical explanation for
the increase in these isolates is that:
a. The blood culture media are contaminated with this organism
b. The hospital ventilation system is contaminated with Staphylococcus epidermidis
c. There has been a break in proper skin preparation before drawing blood for culture
d. A relatively virulent isolate is being spread from patient to patient
9. Which test differentiates E coli O157:H7
a. Manitol
b. Sorbitol
c. Lactosa
10. A clean catch urine sample was taken:
TSI: acid slant/acid butt; no H2S gas produced
Indole: positive
Motility: positive
Citrate: negative
Lysine decarboxylase: positive
Urea: negative
VP: negative
This organism most likely is:
a. Klebsiella pneumoniae
b. Shigella dysenteriae
c. Escherichia coli
d. Enterobacteria cloacae
11. A gram-negative bacillus has been isolated from feces, and the confirmed biochemical
reaction fit those of Shigella. The organism does not agglutinate in Shigella antisera.
What should be done next?
a. Test the organism with a new lot of antisera
b. Rest with Vi antigen
c. Repeat the biochemical test
d. Boil the organism and retest with the antisera
12. Asacarolitic organism, DNasa + Oxidasa +- Moraxella catarrhalis
13. Propionibacterium acnés – Blood culture contamination
14. The reverse CAMP test, lecithinase production, double zone hemolysis, and Gram
stain morphology are all useful criteria in the identification of:
a. Clostridium perfringens
b. Streptococcus agalactiae
c. Propionibacterium acnes
d. Bacillus anthracis
15. CNA and PEA
16. Case: From a pleural liquid it was recoverd a vancomycin, clindamycin (I think and
another antibiotic, can’t remember) susceptible. On sheep blood agar was chewy or
sticky and in McK it was pink, they concluded that it was Klebsiella, what do you do
next?
a. Report Klebsiella
b. It’s not a common site for klebsiella to grow
c. The plates does not match klebsiella
17. A patient with Meningococci in peniciline treatment. A Gram was made and there
where Gram- cocci. It was cultured and at 48 hours there where no organism. What
happened?
a. The diagnostic was erroneous
b. Antibiotic inhibit the bacteria
c. Patient created antibodies against the bacteria
d. Bacteria produced Betalactamasa
18. when you prepare sheep blood agar, what do you do next?
19. Urine for culture and routine completely spilled- obtain a new sample
20. add KOH and a fishy odor comes out- clue cells
21. Parasite that migrates to lungs- Ascaris lumbricoides
22. A 47 year old was in antibiotic treatment. She had diarrhea for 4 consecutive days,
what should you do next?
23. Mycobacterium process
24. Stool sample question
25. 57% Hematocrit is normal in:
a. Male
b. Female
c. One year old
d. New born
26. Siderotic granules: prussian blue
27. transudate
a. Contains bacterias
b. Something about natural cells
c. Inflamation
28. An alkaline urine refrigerated becomes turbid because of:
a. Amorphous urates
b. Wbc
c. Amoruphous phosphates
d. Bacteria
29. Cristales in sinovial fluid
a. Gota
b. Pseudogota
30. Negative strip, clinitest +
a. Glycosuria
b. Juvenile diabetes
31. Urinalisis and everything was ok except ketones 3+
a. Acetest
b. Ictotest
32. Mean of 140 with 2s and falls in 95% what is the range?
33. 4g of NaCl is added to water until 2500ml is reached. What is the concentration?
4/2500=.16%
34. Absorbance=(abs unk/abs std)x [std]
35. Elevated ALT
36. The best diagnostic for an alcoholic
a. AST
b. ALT
c. GGT
37. In which of the following conditions would a normal level of creatine kinase be
found?
a. acute myocardial infarct
b. hepatitis
c. early muscular dystrophy
38. Elevated ALP
a. biliary obstruction
b. hepatitis
39. what should you evaluate in a antacid overload?
40. If the creamy layer of a red tube is discarded and chemistry is done, which result may
be affected?
41. cases of acidosis and alkalosis
42. IDA common case
43. Icteric sample
44. A BUN- Creatinine case
45. Histogram, they presented WBC, RBC y platelets. What is the cause of interference in
the WBC
a. NRBC-
b. Retics
c. platelet clott
46. Breast cancer marker- CA 15-3
47. Antibodies against TSH
a. Carcinoma-
b. Graves
c. Hashimoto
48. What should you do to a pregnant woman that in the 2hpp had 500mg of glucose in
fasting
a. Give glucola
b. Do another fast blood
c. Change to 5 hpp
49. If a particle has the same isolectric point as the pH
a. It moves slowly
b. It moves faster
c. doesn’t move at all
50. Control fall out 3 standard deviations, which rule is broken?
51 Why ANA test is good?
a. Array immuno disease
b. Diagnose of SLE
c. Descartes Sjorgrens
52. Patient with anti-HCV + y anti-HBs +, what does he have?
a. Hep A
b. Hep B
c. Hep C
d. Hep D
53. ELISA was HIV +, What should you do next?
a. Report to the dr HIV +
b. Repeat ELISA with original sample
c. Obtain a new sample
54. Case of a patient that had everything elevated and platelets super high, RBC, Hct
a. Polycythemia vera
b. Polycythemia vera absolute
c. other types of PV that can’t remember
55. Bands of IgG to what their associate?
56. Howell Jolly plate
57. NRBC exercise
58. A plate of a lot of platelets, what do you do?
a. Repeat in the machine
b. Ask for a new sample and process it in the machine
c. Dilute and do a manual count
59. What is RDW
60. 2ml of blood is collected in a .5ml citrate tube, how is affected the pt
a. Decreases because of the inadequate ratio
b. Increases because of the inadequate ratio
c. Normal
61. Aspirin affects?
62. Why RBC in saline are better than those in CPDA-1?
a. Less glucose
b. More donor plasma
63. Girl with menorrhagia and elevated ptt
a. DD
b. Afibrinolemia
c. Ristocetin
64. Mother with mf agglutination
a. do kleihauer to mother’s cell
b. do kleihauer to baby cell
65. Who is the best donor?
a. Patient that received a transfusion 8 months ago
b. Woman that gave birth 4 weeks ago
c. Man that donate blood 10 weeks ago
d. Patient with Hgb in 12
66. To prevent Graft vs Host
Para evitar Host vs Graft que le das
a. Irradiated
b. Leukocyte reduce
67. Temperature for thawing FFP
68. Patient in operating room, intraoperative blood
a. Transfuse the patient in24 hrs if it was maintain at 1-6C
b. Do a crossmatch and then transfuse
c. can give to other patients
69. Lectin use
70. Blood bank panels
. Differentiate btw Enterobacter- Lysine and Arginine
2. Burr cell- uremia
3. Pre-hepatic/ hepatic/ obstruction and bilirubin levels
4. UA results and correlate to disease
5. Couple questions that provide coag results and ask what is wrong. Controls? Instrument?
6. Lupus anticoagulant
7. Rotavirus specimen- stool
8. Differentiate btw EBV and CMV infection
9. serum Na: SIDAH
10. Staph. aureus ferments mannitol
11. Some ABO discrepancy
12. 1 ANA
13. EPO in what? PV? Aplastic anemia?
14. Heinz body stain
15. Pic of polyagglutionation and asked what is the cause? The same pic actually came up 2x LOL
16. Pseudomonas aeroginosa vs putida
17. Catalase pos bacilli in blood culture. Non beta hemolytic, non motile, Penicillin resistant
18. TSI and some biochemical results and what is the organism?
19. Pasturella- cat bite
20. Blastoconidia
21. Legionella test
22. GN anaerobe in blood culture
23. Calculate transferrin saturation
24. Hepatitis marker
25. HTLV confirmation test
26. Which blood group antigen is not stable in storage?
27. What is in the saliva of a Le(a+b-) individual?
28. PCR erroneous results?
29. What causes postprandial lipemia?
30. Treponemal test
31. High Hct in coag sample. What should you do?
32. What does CO2 electrode measure?
33. BGA pH controls
34. serum Na while other electrolytes are normal. What should you do next?
35. Pic of stomatocytes
36. Enterococcus vs Group D strep
37. Aeromonas is oxidase pos
38. 1 panel but it asked about the characteristics of the antibody and not just antibody ID
39. Cushing- hyperglycemia
40. 1 mycology
41. Mycoplasma has no cell wall so penicillin is not effective
42. Monitor PA and NAPA
43. What affects HgbA1c?
44. What can cause a in ESR?
45. False positive in UA reagent strip

2. I will bacteria when exposed to light change color m kansasii


3. Contained tap water m.gonada
4. Anti body panel that had anti k. How would the panel show specific or sensitivity can’t
remember. I choose run enzyme panel not sure is that correct.
5. Had to calculate LDL
6. A questions which had odd results for glucose, sodium, BUN. What would be affected
osmolslity 2na + glucose/20+bun/3
7. Double zone bacteria how to confirmation positive reverse CAMP test.
8. Gram negative anaerobes jaw surgery veillonella
9. A panel that ha anti d and p1
10. Waxy cast or fatty cast I think dye suban o oil.
11. Aeromonas gran negative, beta hemolytic, oxidase positive
12. N meningitis OPNG negative
13. Picture of histoplasma, and one about fluid being drained from the lungs.
14. Picture of aspergillus
15. Zygomycota sporengium
16. Malasezzis furfural- oil or olive oil
17. Auto infection strangyloides
18. Chromogenic agar I think. It was a picture of a agar one side clear organism had
different color sheep blood agar all agate looks the same
19. K ISE- valinomycin
20. Person overdose on salicylate decrease ph- I choose metabolic acidosis
21. ALP ph 9.6- pagets
22. Cocaine metabolite- benzoylecgonine
23. Group A pod mother had and miss carriage d neg, weak d beg… Is the patient a
candidate for rhig
24. I have to calculate diagnose for rhig twice. Whole blood divide by 30. Rbc by 15
25. Hba1c affected by hemolytic anemia
26. Caffein for diazo rxn why?
27. Bilirubin- 450nm
28. Pituitary gland – increased TSH and T4
29. Increase bilirubin and urobilinogen
30. Release heparin/ histamine – basophils and mast cells
31. Cryo store at RT from 2pm pt scheduled to be transfused at 3pm what would you do?
32. Irradiated blood for pt receiving blood from mother
33. Positive RPR negative FTA for syphilis -false positive
34. Pictur of a waxy cast
35. Alpha thalassemia-hgb Bart and Hgb h
36. Eosinophils in Urine/ intestinal nephritis
37. know the difference CML and AML
38. Questions about multiple myeloma
39. Increase platelet and wbc
40. Issoagglutinin of Type O- anti A, anti B, anti AB
41. Beta and gamma bridge
42. HTLV- confirmatory test- western blot

1. Burr cell – uremia


2. pyr – know POS and NEG orgs
3. BE and NaCl – know orgs POS/neg for them (entero, Grp D, Viridans)
4. KNOW TSI slants blindfolded – if its A/A and gas productio0n wht is it.. entero, serratia, s
bovis, grp D strep (my question, I think those were the choices, or close to it)
5. CAMP test POS and NEG ctrls (agalac and pyog)
6. 1 ANA – it had things with like 4 colors green yelloow orange and red all over it looked like a
f-ing picasso painting so I totally guessed
7. know the thyroidism chart for inc and dec in TSH, t4 and T3
8. know PTH effects on Ca+
9. Know about aldosterone inc and dec and when it happens, (Conns) and effect on Na and K
10. Cushings is hyperglycemia
11. PTH and Ca+ relationship
12. something about perfringens i think
13. a tough hemoglobin C question
14. rouleaux is undetectable at what phase
15. CMV best to do viral culture (i think, but i guesses)
16. ESRD (1.010 sg and waxy casts predominate)
17. a couple of thrombin/ antithrombin questions
18. no VWF
19. know about heparin contamination and mixing studies and TT/fibrinogen times
20. HBA1C
21. rotavirus – stool
22. HTLV confirmation testing
23. weak D epitope something
24. whats wrong with this stain – acidic so change pH
25. sezary – t cell or congenital t cell (difference)
26. Amylase – mumps
27. something about rubella I forgot
28. enzyme effect on certain Abs (destroy, enhance)
29. about 4 questions about diabetes ( insipidus, mellitus, the ref ranges for cutoffs for
diagnjosing)
30. Conn’s sydrome Aldo increases
31. jeikiem quesition about somehing idk
32. know different between glom nephritis. Pyelonephritis, nephrotic disesase, (conj, unconj,
urobili)
33. had 1 metabolic acidosis question
34. had the PCR question – denature, anneal, extend
35. had a hypo hashimoto question about tsh inc
36. troponin stays in the system longest
37. 1 syphilis question… just know whats POS and NEG for each of he 3 phases ( the rpr and
VDRL)
38. an aeromonas question where it gives you the rx it was something like oxi POS, and some
other rxns
39. know the TSI slants ( I have a story for common imvic orgs that helps so if you want it let me
know)
40. a really crappy grainy picuture of what looks like rbc agglutination/flocculation/some other
crap … that sais what should you do next – I chose heinz body stain (actually got this exact pic
twice)
41. intrinsic resistances to common drugs (kleb amp R, Micrococcus R furosamide,
stenotrophomonas Bactrim Res , etc)
42. a lot of aldosterone related questions (like 5) and diseases associated with them
43. a couple of coag cascade questions like when to do an F8 assay
44. when to do PT (warfarin therapy)
45. TB testing PPD is T-cell mediated type 4 hypersensitivity rxn
46. know common markers for B and T lymphs (CD 19, 20/ CD 2,3,5,7, 4/8 mature)
47. if pt and ptt are inc what do you do next (exactly waht do you do next)
48. a s-load of bilirubin (like 7) know what happens in prehep, hep, post hepatic and nephrotic
syndrome, when you would expect to see jaundice associated with what Bilirubin, etc
49. absolutely no parasitology
50. no myocology
51. almost no hematology
52. no AB/Ag frequencies
53. know (sensitivity = TP/TP +FN) and those others (SPECificity = TN/TN+TP) (PRECISION =
TP/TP+FP)
54. a bunch of lab ops questions (3 or 4)
55. no HDL.LDL.VLDL
56. a couple of tiny screen panels like if you have nothing thru iat in screen cells 1 and 2 except
patient sample shows up +/- on iat what do you perform next bla bla bla
……..a lot of “what do you perform next questions” related to BB so brush up on panels, DAT,
IAT and discrepancies

ABO compatibility with blood groups-very important


Blood product that has highest capability of transmitting hepatitis
Temperatures for storage of blood products, how long, ABO compatibility and condition
or reason for transfusing product
Platelet temperature and PH- temperature of blood before processing( room temp).
OR schedule- how many units to prepare given blood group and antibody of patient
Kell frequency- 91% negative for antigen
Antigens of ABO system: Le with no Se( Lea+b-), Le with Se ( Lea-b+).
ABO discrepancy- subgroups of A, anti-A1 lectin
Cold antibodies and warm antibodies
Mixed field reactions- check transfusion history first
Controls for D-testing , Du test and AB+ control
Weak D- Missing epitopes, position effect.

IMMUNOLOGY
T-cell, B-cell lymphomas
IgG and IgM- which rises first
Hep A graph: antigen in stool-IgM-IgG
IgE- basophils and mast cells
Classic and alternate pathway complements
RA- IgM produced, autoantibodies to the Fc portion of IgG
FTA, RPR,VDRL, which is for testing reinfection, late stage and early stage
Treponemal antibody agglutination
Infectious mono- reactive lymphs and monocytes
Hepatitis- antigens and antibodies tested for each stage

HEMATOLOGY
Transferring- TIBC
Child swallowed naphthalene ball- Heinz bodies
Heinz bodies- DNA
RBC inclusions and corresponding diseases
Anemias and what to find in RBC- pictures
Sources of error like in ESR and Hb
Stomatocytes- liver disease
Oxidant drugs, anti-malarial drugs effect on RBC
Hemoglobin electrophoresis- cellulose acetate-C S F A and the Hb it migrates with
Hemoglobinopathies- sickle cell solubility test and sources of error
Thalassemia- alpha- Barts and HbH
Beta- cooley’s anemia
Myelodysplastic syndrome- essential thrombocytemia( increase in PLT, splenomegaly).
COAGULATION
Mixing studies
PT & Aptt Factors
Protein C- how aspirin affects test( prolonged, increased or unaffected)
Platelet aggregation_ graph for ADP, epinephrine and collagen
Both PT and Aptt prolonged and then corrected

URINALYSIS
Bilirubin crystals- liver disease
Eosinphils in urine- interstitial nephritis
Monosodium urate- highly birefringent
HCG- pregnancy
Creatnine clearance- (UV/P)*(1.73/A)
Rhabdomyolysis- myoglobin

CHEMISTRY
Glucose levels-nomal and abnormal
ADH- increase water absorption
Iron test
Liver enzymes; hepatobiliary- ALP, GGT, 5NT
Hepatocellular- ALT AST
CK, troponin- MI
Amylase and lipase- pancreatitis, source of error
Solution/buffer for most ISE methods
Blood gases
Bilirubin – conjugated and unconjugated, urobilinogen
Hemolytic, hepatic, biliary obstruction
Immunosuppressant- tacrolimus- use whole blood
Azotemia- increase in BUN
TSH
Pheochromocytoma- VMA
K ISE- valinomycin

MICROBIOLOGY
Anaerobes- chopped meat agar( iron and glycerol)
Micrococcus- resistant to furazilidone
Aeromonas- A/A, oxidase+
Acinetobacter- wounds
Erysipelothrix- H2S+, catalase+
Veillonella(g- cocci) and peptostreptoccus( gram+ cocci) – anaerobes causing jaw
abscess
Picture of agar with chromoblastomycosis
Picture of blastomyces dermatitis
Geotrichum- arthroconidia
K. Pneumoniae and K. Oxytoca( indole+)
How to transport viruses after 96 hrs
Malasezzia furfur- oil
Zygomycota- sporangium

My exam were mainly balanced of all the subjects.


1. Negative, positive control for CAMP, BILE ESCULIN, 6.5% NaCl, Bacitracin
Choices were mainly Strep family. Study them.
2. Hba1c – 5%, FBS – 155mg/dL
– good long term control but poor recently
3. Caffeine for Diazo reaction
– to measure unconjugated bil
4. Enzyme uses pnp maintained in pH 9.8 increase in what dse
– Pagets
5. Elevated lipase buy normal amylase appearance of plasma
– Lipemic
6. Measurement of iron
– step1: addition of acid
– step 2: addition of reducinh agent
– step 3: add color rgt
7. Estrogen increase in pregnant women
– Estriol
8. Female patient on mesntruation
– I forgot the exact choices but I choice the lab results correlating with IDA
9. TIBC
– Trasferrin
10. Stomatocytes
11. Burr cells
12. Echinocytes
13. Alternaria
14. http://library.med.utah.edu/WebPath/IMMHTML/IMMIDX.html
– study the autoimmune diseases part. Slide 4 was on my test. Exact image.
15. Pheocromocytoma, measure
– Cortisol or Metanephrines : torn between these two hahaha
16. Blastoconidia
17. Definition of Oliguria
18. Measurement of FLM
– phosphatidyl
19. Indole positive, A/A TSI
– K. oxytoca
20. Present after jaw surgery
– if the question was looking for gram neg: Veilonella
– if gram pos: Peptostreptococcus
21. Detextion of Rubella
– IgG 2 weeks interval
22. Zygomycete
– i answered the one with sporangiospore
23. The famous HEINZ BODIES on napthalene something haha
I forgot the others. I need to sleep. Lol. Had 3 hours of sleep only. Id post recall
questions when I remembered some

24. SIADH
– decreases Na
25. Case study about urine but the clue was present fat bodies
– Nephrotic
26. Azotemia
– Im really not sure with my answer because the choices have
A. increase bun
B. increase creatinine
But I picked BUN
27. Just remember that in Protein C taking warfarin therapy
– it would decrease
28. The blood glucose was given 390mg/dl, potassium 4.2mmol after insulim
administration glucose is 215 potassium is now? Note that this is kot the exact values
given
– I really do not know the answer but as insulin increase, potassium would decrease.
Just know how to solve this because the choices were values
29. Olive oil
– Malassezia furfur
30. Rotavirus test
– i also dont know the answer but I picked electron microscopy something
31. Sezary cells
– T cells
32. Case study about skin testing blabla
– T cells also
33. Negative and positive control for anti-E
– DcE/DcE, dce/dce
34. Virus specimen was received. What would u do when sending it to other lab or
shipment (cant remember exactly)
– I answered lypholized because shipment of viruses are -70, 4C storage
35. Sensitivity formula
36. Aggregation studies that I dont know. They presented me a graph with collagen, adp
and epinephrine
37. Latex agglutination in S. Aureus
– protein a and clumping factor
38. Know the antibodies that would react at IS, AHG and 37C
39. Antibodies not enhanced by enzymes
40. Bilirubin
– 450nm
41. About ISE
– KCl